Emerging Microbiome-Based Therapies for Skin Infections: From Probiotics and Prebiotics to Synthetic Microbiome Engineering

Abstract: Skin infections are a major global health burden, made worse by the quick development of antimicrobial resistance (AMR) and the poor effectiveness of traditional antibiotic treatments for chronic and recurring diseases. The importance of the skin microbiome in preserving cutaneous homeostasis, pathogen exclusion, and immunological modulation is becoming more and more clear. Many infectious and inflammatory skin conditions have been linked to dysbiosis of the skin microbiota, which has led to a strategic reorientation from pathogen control to microbiome regulation. Probiotics, prebiotics, postbiotics, bacteriophages, microbiome transplants, and new methods in synthetic microbiome engineering are just a few of the recent advances in microbiome-based therapies in skin diseases that are covered in detail in this review. We go into the clinical effectiveness, safety issues, regulatory obstacles, and molecular underpinnings of various therapies. The promise of microbiome-based treatments to lower AMR, improve long-term effectiveness, and restore microbial balance is highlighted by comparison with traditional antibiotics. Lastly, future possibilities are examined that highlight the translational potential of microbiome-centred techniques in dermatology treatments, such as multi-omics integration, artificial intelligence-guided customisation, or synthetic microbial consortia. An infographic on microbiome-based therapies to restore microbial balance and reduce AMR and infections.The infographic illustrates the problem with traditional antibiotics, leading to antimicrobial resistance and chronic infections. It highlights dysbiosis and imbalance in the skin microbiome. Microbiome-based therapies include probiotics, prebiotics, bacteriophages, microbiome transplants and synthetic microbes. The central focus is on restoring microbial balance to reduce antimicrobial resistance (AMR) and recurring infections. Clinical benefits are noted as effective and safe. Innovative approaches include multi-omics, AI-guided methods and phage therapy. Future perspectives involve custom therapies and synthetic consortia. Keywords: skin microbiome, probiotics, prebiotics, postbiotics, bacteriophages, synthetic microbiome engineering, antimicrobial resistance, skin infections